Thursday the 15th of December it was time. After many years of research, Kasper van den Noort (43) was the first in the Netherlands and probably the first worldwide, to get back his own cells from a cultured miniscule salivary glands (organoids) via an injection. Van den Noort spoke of a special moment. 'The injection was a bit sensitive. I am obviously very curious to see what will happen next, whether this will have the effect that was intended. It would be really great if that salivary gland starts working again.'
The stem cell transplantation has to prevent Van den Noort from getting a dry mouth as a consequence of the treatment against the tongue tumour he had.
Earlier this year, Van den Noort was diagnosed with a tongue tumour. He went into surgery for this at the UMCG. During this procedure, part of his salivary glands were removed as well. ‘We cultured stem cells from this in the laboratory’, explains UMCG-professor Radiotherapy Rob Coppes. ‘These form salivary gland organoids which we can multiply. After radiotherapy, which the patient has had in the meantime at our Proton therapy centre, we give back cells of these organoids.’
Diminished quality of life
Annually, there are around 2.500 new patients in the Netherlands with a tumour in the head-neck area. A large part of these patients has a good change of remission after radiotherapy. However, a serious complication is that in case of 40% of the patients, the salivary glands do not work sufficiently anymore after the treatment. The patients therefore continuously suffer from a dry mouth. Chewing and swallowing is difficult, their sense of taste deteriorated. Speaking becomes difficult as well and the teeth are damaged. Therefore, the quality of life of these patients is significantly diminished.
Last steps within the research
To prevent this problem, the research group of Rob Coppes has been investigating salivary gland stem cell therapy for years. About four years ago, Coppes and his colleagues started with the last steps to create a safe method that can be clinically applied. After Kasper van den Noort, a few other patients will undergo this treatment at the start of 2023. This will happen within a clinical study, in which only a limited and selected group of patients can participate.
Determining whether it is successful
‘We hope to determine later next year whether the treatment is successful for the patients’, decides Coppes. ‘This study is meant to be a “proof of principle” that such a treatment is feasible and safe. If we find a positive effect, a follow-up study will focus on treating patients with tumours in other areas who are also at risk of getting a dry mouth after radiotherapy. In the case of success, the so-called organoids technology could perhaps also be applied to other tissues.’
For the past few years, the study conducted by Rob Coppes and his research group has been made possible by grants from KWF and ZonMW.